Reasonable Expectations

Never before, during my almost 30 years as a veterinarian, have I encountered such rapid and profound changes in client expectations. We’ve entered what I like to refer to as “The Age of the Empowered Client”. I’d love to believe that this is a result of so many people reading my book, Speaking for Spot. Alas, I must give credit where credit is due- namely, the worldwide web. Discuss a symptom with my clients and I’m no longer surprised when they pull out their printed list of the diseases Dr. Google feels might be responsible. Render a diagnosis and my client can surf the net to quickly find a plethora of others who have “been there, done that” and are willing to provide advice about how best to navigate any possible medical minefield.

Do I believe these changes in client expectations are a good thing? You betcha! As I convey in Speaking for Spot, my belief is that every animal needs an empowered, adept medical advocate by its side. Of course I want veterinarians to remain essential members of the health care team, but I love it when those at the other end of the leash (or monkey-wrenching their backs schlepping cat carriers) become the team captains!

Over the next several weeks I will write about several previously uncommon client expectations that are now becoming mainstream. They are reasonable expectations in that they ultimately serve what clients and veterinarians hold as common ground- namely, the best interest of the patient. Remember, change is not for everyone- not all veterinarians necessarily “embrace” these changing expectations. Some gentle patience and persistence on your part may be needed. If you find your vet isn’t willing to budge, for your pets’ sake, I encourage you to find a new teammate.

I’m going to describe my favorite client expectation first because, once this expectation is fulfilled, satisfaction of most others will naturally follow. So here we go.  It is perfectly reasonable for you to expect “relationship centered care” from your veterinarian. This is a style of communication in which your vet holds your opinions and feelings in high regard and enough time is allowed during the office visit to hear them. He or she recognizes the unique role your pet plays in your life and is a willing source of empathy and support. Rather than telling you what to do, vets who practice relationship centered care discuss the pros and cons of all options before making a recommendation. They believe in collaborative decision making. Compare this to “paternalistic care” in which the vet maintains an emotional distance and recommends only what they believe is best without consideration of the patient’s or client’s unique situation. There are no significant opportunities for discussion or collaboration.

Relationship centered care is not for everyone- some people truly prefer to be told what to do (certainly the way I feel when my car is in need of repair!). However, if you desire relationship centered care from your vet (or for that matter your own physician), please know that this is a completely reasonable expectation. How do you find a veterinarian who employs this style of communication? At the risk of tooting my own horn, the chapter called “Finding Dr. Wonderful and Your Mutt’s Mayo Clinic” in Speaking for Spot will tell you everything you need to know to fulfill this expectation.

Do you work with a vet who provides relationship centered care? What do you like about his or her communication style?

Now, here’s wishing you and your four-legged best friend abundant good health!

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Become a Fan of Speaking for Spot on Facebook

Please visit  to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at, local bookstores, or your favorite online book seller.

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4 Comments on “Reasonable Expectations

  1. I knew I loved my favorite vet ever when, after he did a dental on my cat, he pulled out a laptop, brought up my cat’s x-rays, and showed me all of the problem areas and how he had resolved them. Without my asking to see them! One of the last times he saw that cat, I reviewed the problems we were having and he said “Okay, let’s talk this through together and decide what we should do.”

    I recognize that a lot of clients aren’t interested in those kinds of detail or participation in care. So I not only am eternally grateful for his willingness to work with me that way but also marvel at the skill it must take to deliver information to individual clients in the way that works best for them.

    There are two skills involved – recognition of what each clients wants and then the ability to deliver the information as desired. Really hard work I think!

    I could not work with a vet who is unwilling to provide relationship-centered care and I’ve seen some terrible results come from people who just want to be told what to do if they don’t happen to choose a skilled veterinarian. I get to know a lot of diabetic dogs through the forum and have seen a lot of near misses that could have ended tragically if the dogs’ families hadn’t reached out for more information.

    So fundamentally, I think better care always comes from more information and participation by clients in their pets’ care.

  2. Dear Nancy. I have to admit that I never aspired to being an empowered client! I would have been quite happy with the passive approach – take the dog to the vet, let them do their thing, do what they said, all done.

    Sadly, this approach has not worked for us. Situation forced me to take full charge of my dog’s health management. In this process we did find a vet who is truly amazing and we were literally shocked how different he is. He is our main vet now.

    With him we do have relationship centered care in the full meaning of that. I leave no stone unturned and he got used to me. Even though my ‘torturing of the vet’ has become an ongoing joke in their office, I think he does appreciate the true interest and challenges.

    I do believe that being an adept medical advocate for one’s pet is really the only way to go. Yes there are some great veterinarians out there, but without knowing a thing or two, how would one even recognize him?

    I find this issue so important that it got me to start blogging.

    What do I like about this communication style? That it allows me to make informed decisions, discuss issues in depth, and end up with truly individual treatment solutions. It made a huge difference for my dog’s well being.

  3. Thanks Nancy

    I enjoy reading your blogs – and agree totally with the ‘new’ approach that some vets are making in the UK.

    I am fortunate enough to have such a vet – although he doesn’t know much about complementary therapies and prefers the scientific approach, he is more than willing to allow me to try these therapies before going down the road of conventional medicine. However, his wife (also a vet in the practice) has introduced acupunture to the clinic and is open to such therapies.

    It is so good to be able to discuss my animals’ care and health issues and be listened to. My vet has time to explain in great detail everything that goes on within my boys and girls’ bodies and knows that I am willing to learn too. It is a good working relationship, whereby we both help each other out in whatever way we can.

    I hope that one day, more vets will take on this approach, for the sake of our animals, who give us so much and enhance our lives beyond all our expectations.

    Judy Robinson